What Actually Happens in Couples Therapy?


Does your relationship feel stuck? Are you and your partner having the same arguments over and over again? Are feeling unsure what to do about it?

Clinical social work trains therapists to look at the person and environment interaction. This is the frame I use with therapy clients when we discuss why the health of their relationships is a critical contributor and consequence of their mental health. For example, irritability is a common symptom of both depression and anxiety, which can make interactions with a partner challenging at times. At the same time, when your relationship does not feel stable, it is easier to feel anxious or depressed.

Couples counseling can be a transformative experience for individual mental health. And yet, for many couples, the idea of talking to a perfect stranger about their personal problems can feel overwhelming and intimidating. Understanding what actually goes on in couples therapy can help to demystify the process and build readiness to make this important step.

There are different counseling options available to couples. I personally recommend the Gottman Method — a highly effective counseling program for couples that is proven by research to help couples better manage conflict, adjust to major life transitions and improve relationship satisfaction. The Gottman Method aims to build healthier relationships that are grounded in friendship and shared meaning.

This is typically what happens in Gottman Method-driven couples therapy:

Session one: The assessment of a couple starts with an initial consultation with both partners to discuss shared goals, areas of concern and next steps in the counseling process. Next, the couple completes the “Relationship Check-Up,” an online set of questionnaires about your relationship that you both fill out separately at home. This research-backed tool allows the therapist to give you targeted and personalized feedback over the course of counseling. You’ll discuss feedback in several domains of healthy partnership over the course of counseling, including friendship and intimacy, conflict resolution and individual areas of concern. You should schedule one to two hours of uninterrupted time to fill these out before your next session.

Sessions two and three: In Gottman style therapy, the therapist then meets with each partner for separate individual sessions. This gives each partner a chance to individually discuss their concerns about the relationship and share more about what they would like to get out of the counseling process. This is also an opportunity for the therapist to give recommendations for individual therapy if that is also indicated. It is not uncommon to participate in both individual and couples therapy at the same time. Having your own individual space to organize your priorities can help you get more out of the couples counseling experience.

Session four: The therapist then meets together again with both partners for the final assessment session to share initial feedback about the health of the relationship, including discussion of strengths and vulnerabilities the couple is facing.

After this thorough assessment, the therapist offers coaching in personalized strategies to improve the relationship in weekly follow-up sessions. Each week the couple focuses on a new theme to discuss specific and practical ways to improve the relationship. The couple adds more and more tools to their relationship toolbox as counseling progresses. The therapist will assign practice exercises for the couple to use together at home to extend the benefits of counseling beyond the counseling hour. These exercises will include practice in communication skills, ideas for improving intimacy and lovemaking and ways to support each other to pursue shared meaning, passion and connection.

Throughout the counseling experience, the therapist works collaboratively with the couple assess how well they are progressing towards their specific goals for the relationship. Both partners are expected to be active agents of change throughout the counseling experience. You can imagine the better you feel as a couple, the better you will feel as an individual. Couples counseling is just another creative way to support your individual mental health.

My question for you is: If you could make one change for the better in your relationship, what would it be?

Anna Lindberg Cedar, MPA, LCSW offers counseling to adults, couples and teens in Oakland, CA. She specializes in helping individuals develop self-care routines and create more rewarding relationships. Find out more: www.annacedar.com . Sign up for Anna’s A Self-Care Moment newsletter and never miss an update.

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Thinkstock photo via vadimguzhva.


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